Four Planned Parenthood clinics in Iowa plan to shutter on Friday, following then-Gov. Terry Branstad’s approval of a budget in May that stripped the organization of its Medicaid funding.

Planned Parenthood officials said the closures will affect one-third of its clinics in Iowa and will cut off access to essential health-care services like cancer screenings and annual checkups for nearly 15,000 women.

The nonprofit organization — which provides birth control, breast cancer screenings and other women’s health services but has become a political lightning rod for its abortion services — says the closures foreshadow what could happen across the country should Republicans’ health-care bill become law. The Senate bill contains a provision, which closely mirrors the Iowa law, that would eliminate Planned Parenthood’s Medicaid funding for one year. Some clinics could lose as much as 40 percent of their funding.

“What’s happening in Iowa is heartbreaking,” Cecile Richards, president of Planned Parenthood Federation of America, said in an email. “If Trumpcare is passed into law, we’ll see that kind of devastation happen nationwide, with far too many women simply going without the health care they need. ”

Community members, Planned Parenthood staff and patients held vigils on Thursday over the closing of the clinics in Burlington, Quad Cities, Keokuk and Sioux City.

More than half of Planned Parenthood patients are insured through Medicaid, according to the organization.

“It’s devastating,” said Burlington resident Laura Blanchard, who has used Planned Parenthood services. She said she knows of only one other reproductive health-care option in her town targeted to low-income women and women on Medicaid.

“This community cannot afford to lose a health-care provider like Planned Parenthood,” she said.

The Planned Parenthood clinics in Burlington, Sioux City and Keokuk provided health care and contraceptives to 80 percent or more of the women in the area, said Beth Lynk, Planned Parenthood’s state policy press officer. Women in Keokuk, a small town located in rural Lee County, will be an hour away from the nearest low-cost family planning provider.

Proponents of defunding Planned Parenthood argue that other providers can absorb Planned Parenthood patients that need family planning services. The state plans to funnel about $3.3 million into a program that would fund family-planning clinics that don’t provide abortions, according to the Des Moines Register.

Branstad, a Republican who is now the U.S. ambassador to China, endorsed the plan during his Condition of the State address in January, saying the budget proposal “redirects family planning money to organizations that focus on providing health care for women and eliminates taxpayer funding for organizations that perform abortions.”

In April, Iowans for Life Executive Director Maggie DeWitte told the Register she supported shifting funds to such community health centers.

“I would say this is fantastic news for women and families in the state of Iowa,” DeWitte said of the Planned Parenthood closures. “We have said from the very beginning that there are many, many other qualified health centers that provide comprehensive health care for women.”

The budget cuts to Planned Parenthood were unpopular among Iowans. In February, a poll conducted by the Des Moines Register found that 77 percent of adults surveyed were in favor of continued funding for the clinics. Additionally, 62 percent of Iowa Republicans surveyed were also in favor of continued funding.

Iowans sentiments are on par with attitudes nationwide, with 80 percent of Americans and 67 percent of Republicans opposed to cutting Planned Parenthood funding, according to a recent Quinnipiac University poll.

As the nation’s largest abortion provider, the 100-year-old nonprofit has sustained attacks at both the state and federal level, although the clinic does not use Medicaid funding to provide abortion services.

Planned Parenthood is planning to close six more clinics in Wyoming, Colorado and New Mexico. The closures were not a result of funding cuts, but concerns over political attacks played a role in the decision, officials said. The clinics also suffered from declining revenue under the Affordable Care Act, which expanded Medicaid to some patients who had previously paid out-of-pocket, officials said. Medicaid reimburses the clinics at a lower rate, they noted.

Once the clinic in Wyoming closes the state will become one of two in the country without a Planned Parenthood clinic, along with North Dakota.

In 2011, the Texas legislature effectively defunded Planned Parenthood by reducing the two-year budget for family-planning funding from $111 million to $38 million. As a result, one out of every four clinics in the state closed.

Correction: An earlier version of this story misspelled the locations of two Planned Parenthood clinics that closed in Iowa. They were the Keokuk and Quad Cities locations.

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Nicole LewisNicole Lewis reported for The Fact Checker. She left The Washington Post in December 2017. Follow

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